On the Trail With...Rattlesnakes

It's no secret the outskirts of Sacramento, Calif., are crawling with rattlesnakes. California's capital city is fully modern, with Starbucks, strip malls, the NBA's Kings and "Ahnold the Govenator." It's just that, like many growing cities in the West, urban life sprawled quickly in the last decade and wildlife didn't go quietly into the night.

Milla Austin, a 30-year-old accountant from nearby Fair Oaks, learned that lesson the hard way last summer during an easy late-evening run on the American River Trail.

Oppressive summer heat encourages most runners and almost every other animal to avoid the 32-mile jewel of a trail on the edge of the city during the day. Milla and her husband, Gabriel Austin, were no exception, leaving the trailhead at dusk with little light to guide their way. No matter, they thought. They knew the trail well. They'd be fine.

They were only about a mile into their run when Milla heard the rustle of a deer and, concerned about how dark the trail was becoming, suggested to Gabriel that they turn around. But her husband wanted to finish the run he had planned and encouraged Milla to continue.

Just seconds later, Milla felt something sharp hit her lower left leg. Stopping immediately, she looked down to see what caused the pain and felt a second piercing jab. "I've been bit! I've been bit!" she screamed. Gabriel ran back to Milla and used the glow from her iPod to look at her leg.

"We could see blood pouring out," Milla recalled. "And then we saw the snake all coiled up, and it began to rattle. When it bit me it hadn't rattled to warn us at all. It just attacked. At that point, Gabriel yelled 'Run!' We both just took off running looking for a call box."

As the couple reached an emergency phone, Milla's leg went completely numb and the sensation was rapidly traveling up her body into her face.

"It took the firemen about 25 minutes to get to us," Milla recounted. "It's not remote, but the driver had to call the park rangers to ask them to open the gates, and then they had to get to us on foot."

Meanwhile Milla borrowed a passing bicyclist's cell phone and called her mom, crying, telling her she loved her and asking her to tell Drew [the couple's 4-year-old son] that "Mommy would always love him." The situation was serious. "I thought I could die," Milla said.

Over her mom's panic, Milla could hear her father, a retired fire battalion chief, intoning in the background, "Nobody dies from a rattlesnake bite. Tell her she'll be fine." Nothing like an impassive dad comment to put the brakes on a highly stressful situation.

But while her father's comment was a calming one for Milla, it was incorrect. In fact, of the roughly 8,000 venomous snakebites reported every year in the U.S., about 10 to 15 are fatal, according to the U.S. Food and Drug Administration.
Milla was rushed by ambulance to Mercy San Juan Medical Center in nearby Citrus Heights, but her condition had worsened by the time she got there. Her leg was dramatically swollen and the pain had heightened considerably. In the emergency room, the attending doctor left Milla with the impression that neither he nor any of the nurses on duty that night had ever seen an actual rattlesnake bite.

The typical medical response to such a severe rattlesnake bite is a dose of antivenom, a manmade serum made from antivenins derived from the venom of live snakes. Antivenom serum treatments are effective on most snake bite victims, but only if administered within an extremely narrow window after a bite.

Milla said she thought they'd give her some antivenom, and she'd soon be on her way.

"I didn't know that we had to wait for symptoms to see if the snake had actually put venom in," she said. "They finally told me that I'd get antivenom an hour and a half after I'd been bit. I was like, 'Thank you!' I just wanted the pain to stop. When they told me that it takes 45 minutes to administer the antivenom, I responded, 'Are you kidding?!' So then they gave me pain medicine called Dilotted."

Even with the meds, Milla's leg was in excruciating pain.

"It was much worse than childbirth," she says. "And I didn't have drugs when I gave birth to my son. This pain was beyond anything I've ever experienced."

In the ICU, the doctors gave Milla four vials of antivenom a day for four days. A surgeon brought onto Milla's case dismissed the notion of amputation and introduced a procedure called a fasciotomy, which entailed long incisions made on each side of the attacked area to relieve pressure on the tissue beneath the skin.

Milla's condition improved, but the surgeon wanted Milla to stay one more day. Instead, she said she "mentally willed" the swelling in her leg to subside and, when it finally did, she was released. Weeks later, the swelling continued to haunt her often, making it impossible to wear shoes.

Several doctor visits later, she learned that the swelling would continue off and on for up to a year.

There is a happy ending to the story. Three weeks later, refusing to allow one measly rattlesnake to interfere with her autumn race plans, Milla finished the Disneyland Half Marathon in Anaheim. But she didn't do it without griping and grumbling that she finished in 3:05:36--50 minutes slower than she had the prior year. Such complaints are clearly a good sign, indicating that Milla is well on her way to recovery.

Snakes on a Trail

Any of 15 species of snakes characterized by a horny rattle at the tip of the tail, rattlesnakes can be found in every state in the U.S., except Hawaii, Alaska, Maine and Delaware. Rattlesnakes prefer hot, dry locations and can often be found lying in the sun from dawn to dusk, April through October. Although not aggressive as a matter of first instinct, rattlesnakes will engage quickly when threatened. It's important to note that rattlesnakes do not have to be coiled to strike and they can swim.

If you encounter a rattlesnake, back away slowly. If bitten, keep the wounded region low and still. Don't apply a tourniquet, don't try to suck the venom out of the wound and don't attempt to cut it out with a knife. Stay calm and don't run around, but try to get medical attention immediately. "If you have nobody to depend on, do what you have to do to get help as quickly as possible," says Dr. Judy Alsop, Director of the Sacramento Division of California Poison Control System.

For more information, call the National Poison Center hotline (800) 222-1222.